How we can reduce maternal mortality in Nigeria —Dr Ola Brown

Dr Ola Brown, a British-Nigerian medical doctor, is the Managing Director of Flying Doctors Nigeria, and the author of Fixing the Healthcare System in Nigeria. In this interview with SEGUN KASALI, she talks about the five pillars of the healthcare system and why she believes the problem of the healthcare system in Nigeria is economical and not clinical.

The youths are regarded as the future of tomorrow but most of these future leaders are neck-deep in drug addiction. As a health specialist, what can they do to get out of this?

One of the key statements that I wrote in my book is that the problem of the healthcare system in this country is not clinical but economical. I also believe that a lot of the problems we are facing in this country are not clinical but economical. So, the impetus for economic growth in this country has never ever been so urgent. The economy right now is growing sluggishly maybe at 1.5 per cent, while the population of the country is growing at 4 per cent and you know what that means is that everybody is getting poorer. The money we are generating is not growing. A lot of the social problems we have in this country like terrorism, crime, kidnapping and so on are caused by poverty. So, the problem of drug addiction is an economical one as well.

A lot of youths are depressed, a lot of youths have mental health issues, a lot of youths are idle and they need to make ends meet and if we have more economic resources and more economic growth, we will be able to help these young people when they have this addiction problem. However, we have not been able to utilise the existing facilities or build new ones. So, a lot of the problem with the youth is as a result of the economic issues we are having in the country and that was what informed one of the chapters in my book called; Sustainable Financing, looking at our economy and how we spend money, we are not able to get advantage especially for our young people.

How do you think women be more impactful in the health sector?

I think we don’t have a choice because we are the most affected here. Of course, it is not men that die in pregnancy and childbirth, it is the women. As you know a lot of women bear the burden of childcare as well and it is also their children that are dying. Every single year, one million of them are dying at about the age of five in Nigeria. I think the book, in a way, is a call out for women in the profession and for experts to start conversations about these issues about the way the lives of women and children can be saved across the continent.

One of the five pillars of effective healthcare system as enunciated and explained in your book entitled; Fixing healthcare system in Nigeria goes along with sustainable healthcare financing, how can Nigeria achieve this?

The five pillars of an effective healthcare system are; the expansion of the primary healthcare, centralisation of the tertiary healthcare, focus on maternal and child health, focus on sustainable healthcare financing and tax shifting. These pillars are very key to achieving effective healthcare system. On the issue of sustainable healthcare financing and how Nigeria can achieve this, there should be a restructuring on how we finance our projects. Healthcare is expensive. In the United Kingdom, it’s over $100,000. In Nigeria; it’s $6. Unless we change the way we spend money, we will not have enough money that can support the healthcare system. One of the ways we can generate money is to explore internal opportunities. We need to be alive to our responsibilities.

As the budget planning preparation is about to set out, what’s your advice to the government regarding the health sector?

What I can advocate for, in my capacity as a concerned citizen, is what I term Soludo energy healthcare. Obviously, he wasn’t working alone, he had a presidential mandate and presidential attention. He was able to reduce the number of banks from 100 to 12 because he had that mandate and the energy was focused on the banking sector reforms as at that time. I want Soludo Energy Healthcare. This complements the centralisation of tertiary healthcare pillar.

What can Nigeria do to contain the high rate of medical tourism?

There will always be procedures to travel for medical attention and hence medical tourism cannot be stopped but the major thing is that effective healthcare system has to be provided for the large number of people. Only 1 per cent of the Nigerian population travels abroad for medical purpose. The problem we have here in Nigeria is that we are not always concentrating on the basics.

How can Nigeria reduce High maternal mortality rate?

There are a number of things we can do to reduce our maternal mortality rate. But I think the most important pillar in the healthcare reform that can affect maternal mortality is the provision of primary health care and making sure that at the early stages of pregnancy; women have access to antenatal care before the baby is born so that high risk pregnancies can be certified according to their risk. Secondly, having good Nigerian specialists and making sure that during the delivery process, women are looked after by these specialists who have been trained to identify complications and manage them accordingly.